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Social Relationships and Mortality Risk: A Meta-analytic Review

Key Message

The influence of social relationships on the risk of death are comparable with well-established risk factors for mortality such as smoking and alcohol consumption and exceed the influence of other risk factors such as physical inactivity and obesity.

Source

Holt-Lunstad J, Smith TB, Layton JB.(2010). Social Relationships and Mortality Risk: A Meta-analytic Review. Public Library of Science: Medicine. 7(7): e1000316. doi:10.1371/journal.pmed.1000316

Purpose

Some experts think that social isolation is bad for human health.  In this study, the researchers undertake a systematic review and meta-analysis of the relevant literature to determine the extent to which social relationships influence mortality risk and which aspects of social relationships are most predictive of mortality.

The researchers identified 148 prospective studies that provided data on individuals' mortality as a function of social relationships and extracted an “effect size” from each study. An effect size quantifies the size of a difference between two groups—here, the difference in the likelihood of death between groups that differ in terms of their social relationships. The researchers then used a statistical method called “random effects modeling” to calculate the average effect size of the studies expressed as an odds ratio (OR)—the ratio of the chances of an event happening in one group to the chances of the same event happening in the second group.

Evidence

The average OR was 1.5. That is, people with stronger social relationships had a 50% increased likelihood of survival than those with weaker social relationships. Put another way, an OR of 1.5 means that by the time half of a hypothetical sample of 100 people has died, there will be five more people alive with stronger social relationships than people with weaker social relationships. Importantly, the researchers also report that social relationships were more predictive of the risk of death in studies that considered complex measurements of social integration than in studies that considered simple evaluations such as marital status.

These findings indicate that the influence of social relationships on the risk of death are comparable with well-established risk factors for mortality such as smoking and alcohol consumption and exceed the influence of other risk factors such as physical inactivity and obesity. Furthermore, the overall effect of social relationships on mortality reported in this meta-analysis might be an underestimate, because many of the studies used simple single-item measures of social isolation rather than a complex measurement. Although further research is needed to determine exactly how social relationships can be used to reduce mortality risk, physicians, health professionals, educators, and the media should now acknowledge that social relationships influence the health outcomes of adults and should take social relationships as seriously as other risk factors that affect mortality.

Benefit Statements / Outcomes

Leadership Provided By:

  • Leisure Information Network (LIN)
  • Alberta Recreation and Parks Association

On Behalf Of:

  • Canadian Parks and Recreation Association (CPRAA)

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